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Outcome and Sequelae of Infectious Encephalitis.

Kathryn A Kvam1, Jean-Paul Stahl2, Felicia C Chow3,4

  • 1Department of Neurology & Neurological Sciences, Center for Academic Medicine, Stanford University, Stanford, CA, USA.

Journal of Clinical Neurology (Seoul, Korea)
|January 5, 2024
PubMed
Summary

Infectious encephalitis often leads to lasting cognitive and neurological impairments. While some symptoms may improve over time, long-term data on sequelae remain limited, necessitating further research.

Keywords:
Flaviviridae infectionherpesvirus infectioninfectious encephalitisoutcomesequelaeviral encephalitis

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Area of Science:

  • Neurology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Acute infectious encephalitis is a recognized clinical syndrome with significant, yet often overlooked, immediate and delayed consequences.
  • Despite its long history, the full spectrum of sequelae and persisting symptoms following infectious encephalitis remains under-investigated.

Purpose of the Study:

  • To review and characterize the clinical picture of patients experiencing sequelae and persistent symptoms months to years after hospitalization for infectious encephalitis.
  • To consolidate available data on cognitive, psychiatric, neurological, functional, and quality-of-life outcomes following various infectious encephalitis etiologies.

Main Methods:

  • A narrative review of case series data was performed, focusing on sequelae after infectious encephalitis.
  • Searched PubMed for studies on encephalitis caused by Herpesviridae, Flaviviridae, alphaviruses, and Nipah virus.
  • Analyzed data from 41 studies involving 3,072 adult patients, assessing outcomes across five domains: cognitive, psychiatric, neurological, global functioning, and quality of life.

Main Results:

  • Most patients are discharged with impairments, frequently exhibiting cognitive deficits like memory loss and attention disorders.
  • Sequelae show a tendency for improvement within several years post-infection for flavivirus or Nipah virus encephalitis.
  • Long-term outcome data are scarce for sequelae resulting from other infectious encephalitis pathogens.

Conclusions:

  • Infectious encephalitis frequently results in persistent impairments affecting multiple domains of patient health and functioning.
  • There is a critical need for further research to comprehensively understand the extent of sequelae.
  • Standardized assessment methods and evaluation of rehabilitation efficacy are required for effective patient management.